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09 Dec 2021

The Dorchester Hotel, Park Lane, London

Know when to walk away

By Caring Times editor GEOFF HODGSON

I think the Care Quality Commission really should abandon the practice of awarding quality ratings. I’ve said it before but I think it needs repeating because quality ratings are helping to drive the market in the wrong direction and exacerbating levels of unmet care needs among elderly people.

Lots of care home operators won’t agree with me; for them quality ratings have become part of the regulatory landscape and for those who have worked very hard to achieve a ‘good’ or ‘outstanding’ rating, they help a bit with marketing.

But I hold to the view that the regulator to should limit itself to policing a minimum, albeit quite high, standard which no care service must fall below, and leave the ratings game to the many websites and what have you which are already out there.

Imagine if MOT inspectors were to examine vehicles on five key areas: brakes, tyres, steering, suspension, engine condition (I think they might need six to encompass lights, wipers, etc) and award a rating for each so that some people would drive away in a car that was merely ‘adequate’, with maybe a couple of advisory notices. I can see the insurance companies rubbing their hands: all those claims they could decline because the owner had failed to notify them of a change in their rating. And would a car with terrific steering, properly adjusted headlights and faultless handling really be outstanding? It would be roadworthy and that’s all we need to know. So no, the Department of Transport’s regulatory division sensibly tells its inspectors to simply determine whether a car is roadworthy or not. CQC inspectors should simply determine if a care home is careworthy or not.

The benefits would be soon in coming; instead of being fixated on pleasing the regulator, the care home team could focus instead on pleasing their residents and operators might feel encouraged to broaden their provision to take in the modestly-heeled many rather than just the wealthy few.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

5 Replies to “Know when to walk away”

  1. Social Care regulation has been going in the wrong direction for 20 years. It was “invented” and built up by influential people who didn’t know much about social care, enthusiastically adopted by people who profit from it, and colluded with by people who should have known better but preferred to go along with it and advance their careers. Star and quality ratings are a symptom and extension of the basic error. Now we have a social care system which is dominated by inspection and regulation. Effective change will mean dismantling the “industry” that claims to prioritise care but is now in the hands of big business and parisitical sycophants.

  2. At a conference last year I was asked “how many sub-standard homes are there in the UK?”. My response of “None” was greeted with disbelief but I explained that every home which holds registration must be of an acceptable standard. So, it would seem that the minimum standard adopted by the regulators may not match that which society adopts? Perhaps, comfortable seating needs to be an MOT criteria??

  3. I don’t agree because leaving the market to decide what is ‘outstanding/good/terrible etc’ would be abandoning the consumer. But your point is well made

  4. Just thinking about the analogy with Trip Advisor: is there something about the CQC rating being in some way official, and not subjective in the way a Trip Advisor review is, that’s part of its value? (I’d also point to CQC trying to go beyond a ‘single issue/experience’ that review sites focus on, and look (however imperfectly) at people’s experience in the round).

  5. Care is not an industry, a market, or even a service; it’s a relationship that sometimes has to be paid for. The “hard” components of social care such as accommodation, catering, equipment, and record keeping are of course important and they can be rated. They can appear to be “outstanding” yet leave people socially and emotionally abused and bereft. The heart of care – caring, involved, close relationship – can be evaluated only by the person who is being cared for and sometimes their family and friends. CQC repeatedly fails to pick up what is deeply wrong with the care in a home (or private hospital) and tells people that the place is just fine. They are simply doing it wrong but believe that putting more effort into doing it wrong will put it right. It’s unfit for the job – an expensive and dangerous failure.

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